Family Left With $200,000 in Unpaid Bills – And They Had Insurance

Even when you have insurance, you still expect to pay something out of pocket such as deductibles, co-pays and miscellaneous items that might not be covered. It’s the way the healthcare system works; but at what point do out of pocket expenses become unreasonable?

What IS covered?

In the past, most Americans with healthcare insurance have assumed that the majority of their medical needs are covered under their policy. We’ve been accustomed to asking, ‘What isn’t covered?’ Perhaps the better question might be – ‘What is covered?’ The answers to those questions don’t really matter is your insurance agent simply lies to you. That’s what happened to an unsuspecting California family. They purchased healthcare insurance from Mega Life Insurance Company and their agent told them that the plan would cover the majority of any needed procedures. In fact, according to the complaint recently filed in a California state court, their agent told them that themost they would have to pay out of pocket would be $15,000.

Unfortunately, the family didn’t find out the truth until it was too late. The wife was diagnosed with colon cancer, but their policy only covered a small percentage of hospital stays and chemotherapy treatments. After all was done and said, the family ended up paying $200,000 in out of pocket expenses.

Just another of many lawsuits filed

This lawsuit is just one of the many filed against Mega Life, its sister company Mid-West National and its parent company HealthMarkets. The circumstances of each case are different, but the result always seems to be the same – denied claims. The situation has gotten so bad that seven states have fined the company and 36 others have joined forces to investigate the way the company does business.

Insurance regulators are especially wary of the company’s practices requiring many policyholders to join an association in order to get insurance. The association fees are nearly $40 per month and include an upfront joining fee of $100.

Enough is enough

Consumers shouldn’t have to be at the mercy of insurance companies to get their medical bills paid. And they should be able to rely on their insurance agent for accurate information about what is covered and what is not. It’s a simple transaction when you really look at it. However, it becomes more complicated when you’re not getting what you thought you purchased. With so many lawsuits filed against the company, consumers are saying ‘enough is enough’ already – and with good cause.

If an insurance agent sold you a healthcare policy that turned out to be anything but what was promised, contact an attorney who understands how insurers operate. To contact an attorney near you, click here.

Back To Library Index